Fracture-related infection (FRI) is a common and serious complication in trauma surgery. Accurately estimating the impact of this complication has been hampered by the lack of a clear definition. The ...absence of a working definition of FRI renders existing studies difficult to evaluate or compare. In order to address this issue, an expert group comprised of a number of scientific and medical organizations has been convened, with the support of the AO Foundation, in order to develop a consensus definition.
The process that led to this proposed definition started with a systematic literature review, which revealed that the majority of randomized controlled trials in fracture care do not use a standardized definition of FRI. In response to this conclusion, an international survey on the need for and key components of a definition of FRI was distributed amongst all registered AOTrauma users. Approximately 90% of the more than 2000 surgeons who responded suggested that a definition of FRI is required. As a final step, a consensus meeting was held with an expert panel. The outcome of this process led to a consensus definition of FRI.
Two levels of certainty around diagnostic features were defined. Criteria could be confirmatory (infection definitely present) or suggestive. Four confirmatory criteria were defined: Fistula, sinus or wound breakdown; Purulent drainage from the wound or presence of pus during surgery; Phenotypically indistinguishable pathogens identified by culture from at least two separate deep tissue/implant specimens; Presence of microorganisms in deep tissue taken during an operative intervention, as confirmed by histopathological examination. Furthermore, a list of suggestive criteria was defined. These require further investigations in order to look for confirmatory criteria.
In the current paper, an overview is provided of the proposed definition and a rationale for each component and decision. The intention of establishing this definition of FRI was to offer clinicians the opportunity to standardize clinical reports and improve the quality of published literature. It is important to note that the proposed definition was not designed to guide treatment of FRI and should be validated by prospective data collection in the future.
In this document, we propose a universal definition of heart failure (HF) as a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and ...corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. We also propose revised stages of HF as: At risk for HF (Stage A), Pre-HF (Stage B), Symptomatic HF (Stage C) and Advanced HF (Stage D). Finally, we propose a new and revised classification of HF according to left ventricular ejection fraction (LVEF). This includes HF with reduced ejection fraction (HFrEF): symptomatic HF with LVEF ≤40%; HF with mildly reduced ejection fraction (HFmrEF): symptomatic HF with LVEF 41-49%; HF with preserved ejection fraction (HFpEF): symptomatic HF with LVEF ≥50%; and HF with improved ejection fraction (HFimpEF): symptomatic HF with a baseline LVEF ≤40%, a ≥10 point increase from baseline LVEF, and a second measurement of LVEF > 40%.
Social media marketing is an integral element of 21st-century business. However, the literature on social media marketing remains fragmented and is focused on isolated issues, such as tactics for ...effective communication. The current research applies a qualitative, theory-building approach to develop a strategic framework that articulates four generic dimensions of strategic social media marketing. Social media marketing scope represents a range from defenders to explorers, social media marketing culture includes the poles of conservatism and modernism, social media marketing structures fall between hierarchies and networks, and social media marketing governance ranges from autocracy to anarchy. By providing a comprehensive conceptualization and definition of strategic social media marketing, this research proposes an integrative framework that expands beyond extant marketing theory. Furthermore, managers can apply the framework to position their organizations on these four dimensions in a manner consistent with their overall corporate mission and objectives.
•This research presents a new and holistic definition of social media marketing.•Social media marketing is cross-functional and interdisciplinary.•Social media marketing dimensions include culture, scope, structure, and governance.•Findings are integrated in a holistic social media marketing framework.•The management of strategic social media marketing is highly complex.
•In a series of laparoscopic choledochal cyst operations, 4 K imaging was rated as being superior to 2 K imaging by a panel of independent assessors.•4 K imaging enhanced performance appeared to be ...owing to improved resolution.•4 K imaging reduced total cyst excision and operative times significantly.•4 K imaging lowered coefficients of variation during cyst excision and suturing.
The safety and success of laparoscopic choledochal cyst surgery (LapCC) depends upon two critical elements during the hepaticojejunostomy anastomosis (HJA). These may be termed the Difficulty of Differentiation (DOD) and the Difficulty of Suturing (DOS). The type of imaging system (2 or 4 K) used may influence either of these. We compared outcomes of LapCC using 2 or 4 K imaging systems.
LapCC were performed at a single institution by the same team using a 2 K system (2009–2018; n = 26) and a 4 K system (2018–2019; n = 11) were compared. 4 K cases were chosen to match 2 K cases to minimize bias. Five independent senior pediatric surgeons scored DOD and DOS blindly from intraoperative video recordings of LapCC using a subjective 5-point scale (5: impossible, 4: difficult, 3: tedious, 2: slow, and 1: easy) and rated their over all impression as +1 if 4 K was better, 0 if they were the same, and -1 if 4 K was worse. Total HJA anastomosis time (TAT) and TAT/suture were also calculated.
LapCC was performed in 37 age/weight/HJA diameter matched children. Scores for DOD (p<0.001) were lower with 4 K with less variance, although there was no difference in DOS (p = 0.08). Operative time (p = 0.03) and duration of hospitalization (p < 0.001) were significantly shorter with 4 K. 4 K was rated +1 unanimously. There was no difference in TAT (p = 0.17) and TAT/suture (p = 0.22).
There was one HJA leak with 2 K (3.8%) and no complications with 4 K.
Improved resolution with 4 K improved the progress of surgery as reflected by shorter operative time and duration of hospitalization, enhancing the performance of LapCC in children.
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We present a study of subjective and objective quality assessment of compressed 4K ultra-high-definition (UHD) videos in an immersive viewing environment. First, we conduct a subjective quality ...evaluation experiment for 4K UHD videos compressed by three state-of-the-art video coding techniques, i.e., Advanced Video Coding, High Efficiency Video Coding, and VP9. In particular, we aim at investigating added values of UHD over conventional high definition (HD) in terms of perceptual quality. The results are systematically analyzed in various viewpoints, such as coding scheme, bitrate, and video content. Second, existing state-of-the-art objective quality assessment techniques are benchmarked using the subjective data in order to investigate their validity and limitation for 4K UHD videos. Finally, the video and subjective data are made publicly available for further research by the research community.
Human mental workload is arguably the most invoked multidimensional construct in Human Factors and Ergonomics, getting momentum also in Neuroscience and Neuroergonomics. Uncertainties exist in its ...characterization, motivating the design and development of computational models, thus recently and actively receiving support from the discipline of Computer Science. However, its role in human performance prediction is assured. This work is aimed at providing a synthesis of the current state of the art in human mental workload assessment through considerations, definitions, measurement techniques as well as applications, Findings suggest that, despite an increasing number of associated research works, a single, reliable and generally applicable framework for mental workload research does not yet appear fully established. One reason for this gap is the existence of a wide swath of operational definitions, built upon different theoretical assumptions which are rarely examined collectively. A second reason is that the three main classes of measures, which are self-report, task performance, and physiological indices, have been used in isolation or in pairs, but more rarely in conjunction all together. Multiple definitions complement each another and we propose a novel inclusive definition of mental workload to support the next generation of empirical-based research. Similarly, by comprehensively employing physiological, task-performance, and self-report measures, more robust assessments of mental workload can be achieved.
Although tourism destination image (TDI) has been extensively studied, the nature and scope of TDI remain vague. This study aims to address this conceptual problem from a modernist perspective. ...Forty-five representative TDI definitions are analyzed, and a new definition is proposed by adopting a “seven-step” procedure derived from definition theory in logic studies. Results show that (1) currently TDI is defined mainly as the mental/total impressions/perceptions held by tourists pertaining to a destination, (2) such definitions are quasi-theoretical in type and created by roughly following the connotative definition technique, (3) the quality of these definitions is generally low, and (4) the new definition proposed in this study better captures the essence of TDI and considerably reduces TDI’s internal and external vagueness. In defining a key tourism concept, this study has notable implications for advancing TDI research and defining tourism concepts more rigorously.
This work addresses slums definition according to UN-Habitat, and provides some objectives of impact evaluation of slum upgrading projects. The main objective is to clarify the importance behind the ...slum upgrading projects (interventions), through over viewing the slum upgrading interventions and their main characteristics then summarize methodology of evaluation studies. This paper gives an overview of counterfactual question, qualitative and quantitative methodologies discusses main strategies to control bias in Quasi-experimental approaches, and provides a summary about common past evaluation challenges and recommendations which can be applied to future work.
Drawing on Moreno's cognitive-affective theory of learning with media, this research aims to investigate the effectiveness of different multimedia glosses on learners' vocabulary acquisition and ...reading comprehension in a CALL environment. A total of 160 university students who learnt English as a foreign language (EFL) in four classes participated in the study and were exposed to one of the four conditions: (a) L2 definition only, (b) L2 definition coupled with audio, (c) L2 definition plus video, and (d) L2 definition with picture. Participants were asked to read eight hypermediated reading texts. Reading comprehension as well as vocabulary acquisition were measured using a pretest-posttest design. The results show first that all these four conditions led to students' vocabulary gains. More specifically, participants who had access to L2 definition plus picture and plus videos achieved significantly higher scores than the other two groups, L2 definition coupled with audio and L2 definition only. Concerning reading comprehension, all multimedia glossing presentation led to better reading comprehension, but no differences were found among all the glossing groups. The questionnaire and interview data indicate that students preferred L2 definition coupled with video and picture glosses, followed by audio and L2 definition only. The results reflect that multimedia glossing presentation creates a different effect on students' vocabulary acquisition and reading comprehension, respectively. They also provide pedagogical implications for learning in times of COVID-19.
The importance of compassion is widely recognized and it is receiving increasing research attention. Yet, there is lack of consensus on definition and a paucity of psychometrically robust measures of ...this construct. Without an agreed definition and adequate measures, we cannot study compassion, measure compassion or evaluate whether interventions designed to enhance compassion are effective. In response, this paper proposes a definition of compassion and offers a systematic review of self- and observer-rated measures. Following consolidation of existing definitions, we propose that compassion consists of five elements: recognizing suffering, understanding the universality of human suffering, feeling for the person suffering, tolerating uncomfortable feelings, and motivation to act/acting to alleviate suffering. Three databases were searched (Web of Science, PsycInfo, and Medline) and nine measures included and rated for quality. Quality ratings ranged from 2 to 7 out of 14 with low ratings due to poor internal consistency for subscales, insufficient evidence for factor structure and/or failure to examine floor/ceiling effects, test–retest reliability, and discriminant validity. We call our five-element definition, and if supported, the development of a measure of compassion based on this operational definition, and which demonstrates adequate psychometric properties.
•Compassion is recognized as important across many sectors of society.•There is lack of consensus on definition and few self/observer-rated measures exist.•Five elements of compassion are proposed after consolidating existing definitions.•The psychometric properties of measures could be improved, limiting their utility.•A new measure of compassion with robust psychometric properties is needed.
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